This 60-year-old patient presented with progressive proximal upper and lower extremity muscle weakness of two months duration.
Which of the following terms best describes the morphologic alterations?
A. Ragged red fibers
B. Perifascicular necrosis
C. Acutely angulated
D. Normal biopsy
This medium magnification image shows basophilic regenerating (black arrows) and pale staining centrally necrotic muscle fibers (white arrows) in a perifascicular distribution. Note the presence of mild chronic lymphoid inflammation within the endomysium.
This medium magnification image also shows the pale staining centrally necrotic muscle fibers (white arrows) in a perifascicular distribution.
Correct Answer: Perifascicular necrosis
The presence of necrotic and regenerating muscle fibers in a perifascicular distribution is categorized as perifascicular necrosis. A perifascicular pattern of muscle fiber injury may be seen patient’s with dermatomyositis and anti-synthetase syndrome.
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